Some Patients May Be Asked to Stop Dialysis

Kidney patients who are old and suffering from other end-stage diseases could be asked to consider foregoing dialysis under new guidelines put forward by renal care experts, The New York Times reports. Specialists want to be able to urge these older, sicker patients to instead enter a hospice and undergo what doctors call "medical management without dialysis."

A federal law that Congress passed in 1972 provides nearly free care to almost all patients with kidney failure, including those already near death.

“Clearly, when the program was initiated in the 1970s, the hope and expectation was that this program would return otherwise healthy people back into society so they could work and be productive,” said Dr. Manjula Kurella Tamura, a kidney specialist at Stanford.

Dialysis is difficult procedure even for comparatively young patients. But people over 75 make up the fastest-growing group of dialysis patients in America. And most elderly dialysis patients have other serious diseases like diabetes and stroke. End-stage kidney disease will cost the nation an estimated $40 billion to $50 billion this year.

But the choice is still the patient's. One 78-year-old woman interviewed by the Times on condition of anonymity said she chose dialysis despite doctors telling her she was not a good candidate. She has diabetes, high blood pressure, a heart valve problem and severe coronary artery disease.

“Some life is better than no life," the woman said. “I go to dialysis because I want to live."